Radiographic evaluation of immediate loading safety after surgical reduction in acetabular fractures ?? a comparative-retrospective study

Objective: Radiographically evaluate the quality of reduction over six weeks of follow-up in patients with surgically treated deviated acetabular fractures who underwent rehabilitation with immediate loading as tolerated and compare this with the results of the unloaded protocol. Methods: We retrospectively evaluated the records of 137 patients with deviated acetabular fractures treated with open reduction and internal fixation. Sixty-six (48.2%) patients underwent postoperative rehabilitation with immediate loading as tolerated, while 71 (51.8%) patients completed rehabilitation using a no-load protocol. The quality of the reduction was assessed radiographically by measuring the fracturing step and gap on radiographs taken immediately after surgery and three and six weeks after surgery. Results: Comparing the joint step, group 1 had an average of 0.44 +/- 1.4 mm, 0.47 +/- 1.5 mm, and 0.51 +/- 1.6 mm immediately, three and six weeks after surgery, respectively. Group 2 had a mean step of 0.24 +/- 0.8 mm, 0.27 +/- 0.9 mm, and 0.37 +/- 1.2 mm immediately, three, and six weeks after surgery. No statistically significant differences were observed between the groups. With a joint gap, group 1 had a mean of 1.89 +/- 1.7 mm, 2.12 +/- 1.8 mm, and 2.36 +/- 2.1 mm; and group 2 had a mean of 2.16 +/- 2.4 mm, 2.47 +/- 2.6 mm, and 2.67 +/- 2.8 mm in the immediate postoperative period, three, and six weeks, respectively. There was also no statistical difference between groups in these measurements. Conclusion: Immediate loading after surgical treatment of deviated acetabular fracture had no negative impact on radiographic reduction parameters and had similar results to the protocol without weight bearing. Level of evidence III; Therapeutic Retrospective Cohort Study.